Dr. Richard Bougher
Unit 6, 1 Station St
SUBIACO 6008
PHONE: 62676200
FAX: 62676210
MOBILE: 0413042768
M.B.B.S. F.R.C.A. F.A.N.Z.C.A.
ANAESTHETIST
PROVIDER NO. 043867DF
richardbougher@mac.com
Information about Anaesthesia
I am a medical doctor with an additional 6 years of specialist anaesthetic training. This training focused
on anaesthesia, the control of pain, resuscitation of the sick and injured, management of medical
emergencies, and intensive care. I participate in ongoing educational activities, practice evaluation and
emergency response education as mandated by the Australian & New Zealand College of Anaesthetists.
As your anaesthetist I will be with you throughout, and immediately after, your procedure. I care for you
while you are recovering and take an active role in your post operative pain management.
The pre-anaesthetic consultation is important as it gives me the opportunity to review your medical
history and any potentially complicating factors, request investigations if necessary, and plan accordingly.
I may need to discuss your medical history with other professionals involved in your care. Appropriate
choices of anaesthetic and management of post-operative pain will be discussed with you. I encourage
you to ask questions relating to anaesthesia (my contact phone number is 0413042768).
Important information you will need to disclose
 Your general health and medical history (both past and present), including diabetes, heart disease, the
presence of pacemakers and other implanted medical devices (e.g. lap bands), high blood pressure,
lung disease, and bleeding disorders. Any history of chest pain, heart palpitations, leg or lung clots,
fainting or dizzy spells, shortness of breath, sleep apnoea, wheezing, seizures.
 Any previous surgery and anaesthesia including any minor or major complications, or any problems
anaesthetists have encountered whilst caring for you.
 Allergies or adverse reactions to medications, tapes, antiseptics, and latex rubber.
 Any serious anaesthetic problems in blood relatives.
 Medications you are taking, including any non-prescription treatments. Consumption of cigarettes
(cessation of smoking improves surgical outcomes), alcohol and recreational drugs.
 The existence of loose teeth, caps, bridgework, plates or dentures.
 Whether you have a hiatus hernia or heartburn (reflux) at night or on bending over.
 Some surgical procedures may necessitate blood product transfusion. If you have any reservations
please discuss these with me. Alternatives to blood transfusion may be possible.
Fasting on the day of surgery
Fasting is essential to prevent the dangerous complication of regurgitation during anaesthesia. If you are
scheduled for morning surgery please do not eat after midnight. Fluids (clear juice, water, tea or coffee
with minimal milk) may be consumed up until you leave home to go to the hospital. If you are scheduled
for surgery after 1pm, you may have a light breakfast at 7am, and continue fluids until 11am. Unless told
otherwise by the surgeon, regular medications including pain killers and anti acid medications should be
taken in the usual manner. I will inform you of any exceptions.
Pre-medication
Pre-medication tablets or injections may occasionally be given to reduce anxiety and make you sleepy
just prior to surgery. It is your choice whether or not to have a “pre-med”.
Same day surgery and procedures
The anaesthetic or sedation does not wear off immediately and so a responsible adult must accompany
you home after the operation and stay with you overnight. During the 24 hours following anaesthesia it is
advisable to NOT drive (insurance companies are not obliged to cover claims made for accidents during
this period), operate machinery, drink alcohol, make major decisions or take part in activities that are
dependent on full concentration or judgement.
Risks associated with anaesthesia
Like any medical procedure, anaesthesia including sedation does carry some risks. Common, but shortlived, minor complications such as shivering, nausea, vomiting, sore throat, dizziness, tiredness,
tenderness and pain or bruising at the site of intravenous injection may occur.
Less commonly, headache, muscle pains, damage to teeth, tongue and lips, eyes, vocal cord injury and
infection may occur. You may experience side effects of medications used during and after anaesthesia.
Serious complications such as allergic reactions, jaundice, nerve injury (the risk of damage due to a nerve
block is 1 in 2500), blood clots, respiratory complications including pneumonia, loss of vision, and
damage to the heart, blood vessels, kidneys, liver and brain are very uncommon.
Important concerns to some patients are the possibilities of being awake during general anaesthetic, or
experiencing pain during local or regional anaesthetic, or dying as a result of anaesthesia. With improved
monitoring methods and rigorous training, these are very rare occurrences. The estimated risk of death
directly or indirectly related to anaesthesia is about 1 in 50,000. Moreover, this is usually in patients who
have serious illnesses. Unexpected anaesthetic complications causing death in healthy patients is an
extremely rare event – much less than the risk of serious injury or death whilst travelling in a car.
Every precaution is taken to minimise potential complications. If you require any further information
please ask. Is there anything you do not understand? It can be useful for you to know the drugs and
techniques used and complications experienced, if any, in case you undergo anaesthesia in the future. If
you would like any details of your anaesthetic I can provide them for you (phone 0413042768). Useful
information can also be found at www.asa.org.au and at www.preop.com.au
Anaesthetic fee
The fee for anaesthesia is separate from the those charged by the institution in which the service takes
place and other doctors caring for you. This fee has been calculated according to the Australian Medical
Association List of Fees. It is determined by the pre-op consultation, complexity of the procedure, nerve
blocks, special monitoring, the health and age of the patient, and the duration of anaesthesia. Depending
on what private health insurance you have there is often a gap between the actual anaesthetic fee which
you are required to pay and the amount reimbursed from Medicare and private health insurance. It is
generally not possible to provide an exact cost prior to operation because the anaesthesia fee will vary
depending on the duration of the anaesthetic services. However, an estimate of the total fee payable
within 30 days and also the gap can be provided for you. Please discuss with me prior to your surgery
any concerns regarding payment of the anaesthetic fee.